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NPI Code Detail

MEDICARE: DR. KERRI MCGRAIL DDS

MEDICARE: DR. KERRI MCGRAIL DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019.032495IL

General Provider Information

NPI Number : 1568026730
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KERRI MCGRAIL DDS
Provider Business Mailing Address
First Line : 851 PARK DR STE 101
Second Line :
City : LAKE GENEVA
State : WI
Zip : 53147-4586
Country : US
Telephone Number : 262-248-4991
Fax Number :
Provider Business Practice Location Address
First Line : 851 PARK DR STE 101
Second Line :
City : LAKE GENEVA
State : WI
Zip : 53147-4586
Country : US
Telephone Number : 262-248-4991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2019
Last Update Date : 01/06/2021

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Directions to “ DR. KERRI MCGRAIL DDS” Practice Location

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